Ventilatory Efficiency, Capacity and Lung Volumes in Healthy Children

Kjellman, Bengt

doi:10.3109/00365516909078082

Cited by 12 publications

(4 citation statements)

References 35 publications

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“…FRC overestimation). Estimation and correction of tissue N 2 contribution is difficult due to limited available data to base correction [96], and adjustment for tissue N 2 is not currently recommended [97].…”

Section: Impact Of Inert Gas Choicementioning

confidence: 99%

Consensus statement for inert gas washout measurement using multiple- and single- breath tests

Robinson¹,

Latzin²,

Verbanck³

et al. 2013

Eur Respir J

681

1,007

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Inert gas washout tests, performed using the single-or multiple-breath washout technique, were first described over 60 years ago. As measures of ventilation distribution inhomogeneity, they offer complementary information to standard lung function tests, such as spirometry, as well as improved feasibility across wider age ranges and improved sensitivity in the detection of early lung damage. These benefits have led to a resurgence of interest in these techniques from manufacturers, clinicians and researchers, yet detailed guidelines for washout equipment specifications, test performance and analysis are lacking. This manuscript provides recommendations about these aspects, applicable to both the paediatric and adult testing environment, whilst outlining the important principles that are essential for the reader to understand. These recommendations are evidence based, where possible, but in many places represent expert opinion from a working group with a large collective experience in the techniques discussed.Finally, the important issues that remain unanswered are highlighted. By addressing these important issues and directing future research, the hope is to facilitate the incorporation of these promising tests into routine clinical practice.

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Section: Impact Of Inert Gas Choicementioning

confidence: 99%

Consensus statement for inert gas washout measurement using multiple- and single- breath tests

Robinson¹,

Latzin²,

Verbanck³

et al. 2013

Eur Respir J

681

1,007

View full text Add to dashboard Cite

show abstract

“…Alternative hypotheses are that this difference could be related to the technology involved (since washouts were performed using very different apparatus), to the effects of body nitrogen or to the use of pure oxygen during washout. Although the earlier studies did not show a major impact of allowing for the effect of body nitrogen in healthy lungs [14], the process may be quite different in those with ventilation heterogeneity. During the later phases of the washout the best ventilated lung regions will have been washed clear of tracer and in the nitrogen washout will contain 100% O 2 .…”

Section: Introductionmentioning

confidence: 80%

“…Kjellman described MBNW in healthy children, and also reported that any error due to excreted nitrogen was both small and less than that due to technical factors associated with the apparatus in use at that time [14]. His correction equations for clinical data, using the height of a typical 10 year old child (145 cm), would predict an error in FRC of 3.8% and in LCI (corrected for the erroneous FRC) of 0.8%.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the Impact of Alveolar Nitrogen Excretion on Indices Derived from Multiple Breath Nitrogen Washout

Nielsen

Horsley

2013

PLoS ONE

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BackgroundA large body of evidence has now accumulated describing the advantages of multiple breath washout tests over conventional spirometry in cystic fibrosis (CF). Although the majority of studies have used exogenous sulphur hexafluoride (SF6) as the tracer gas this has also led to an increased interest in nitrogen washout tests, despite the differences between these methods. The impact of body nitrogen excreted across the alveoli has previously been ignored.MethodsA two-compartment lung model was developed that included ventilation heterogeneity and dead space (DS) effects, but also incorporated experimental data on nitrogen excretion. The model was used to assess the impact of nitrogen excretion on washout progress and accuracy of functional residual capacity (FRC) and lung clearance index (LCI) measurements.ResultsExcreted nitrogen had a small effect on accuracy of FRC (1.8%) in the healthy adult model. The error in LCI calculated with true FRC was greater (6.3%), and excreted nitrogen contributed 21% of the total nitrogen concentration at the end of the washout. Increasing DS and ventilation heterogeneity both caused further increase in measurement error. LCI was increased by 6–13% in a CF child model, and excreted nitrogen increased the end of washout nitrogen concentration by 24–49%.ConclusionsExcreted nitrogen appears to have complex but clinically significant effects on washout progress, particularly in the presence of abnormal gas mixing. This may explain much of the previously described differences in washout outcomes between SF6 and nitrogen.

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Reference Values for Lung Function in White Children and Adults

Cotes¹

2020

Cotes’ Lung Function

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Ventilatory Efficiency, Capacity and Lung Volumes in Healthy Children

Cited by 12 publications

References 35 publications

Consensus statement for inert gas washout measurement using multiple- and single- breath tests

Consensus statement for inert gas washout measurement using multiple- and single- breath tests

Evaluation of the Impact of Alveolar Nitrogen Excretion on Indices Derived from Multiple Breath Nitrogen Washout

Reference Values for Lung Function in White Children and Adults

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